Healthcare Provider Details

I. General information

NPI: 1578492013
Provider Name (Legal Business Name): LESLIE SOLIS IBCLC, RN.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10342 BEVIS AVE
MISSION HILLS CA
91345-2102
US

IV. Provider business mailing address

10342 BEVIS AVE
MISSION HILLS CA
91345-2102
US

V. Phone/Fax

Practice location:
  • Phone: 818-515-9141
  • Fax:
Mailing address:
  • Phone: 818-515-9141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number95190968
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number95190968
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-320354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: